There are several issues that routinely arise in Cape Cod workers’ compensation cases. One of these is the payment or reimbursement of the injured employee’s medical expenses.
Ideally, the employee’s medical expenses would be paid in the regular course of business following his or her accident or illness, so long as certain conditions were met (such as seeing a doctor who was approved by the employer’s workers’ compensation insurance carrier). Sometimes, however, this does not happen, and the employee must seek assistance from the court.
Even if the workers’ compensation insurance company initially refused to pay the injured worker’s medical expenses, the court may order the company to pay such expenses, either directly to the medical providers or as reimbursement to the worker (or, sometimes, to a health insurance company that paid the expenses on the worker’s behalf). Of course, there are sometimes situations in which the court finds that the workers’ compensation insurance company was not obligated to make such payments.
Facts of the Case
The claimant in a case recently considered on appeal by the Massachusetts Supreme Judicial Court was a man who was injured on the job. He sought to be reimbursed for nearly $25,000 of what he claimed was “necessary and reasonable” medical expenses in the form of medical marijuana. According to the claimant, he needed the medical marijuana because of chronic pain resulting from two on-the-job injuries (one in 2010 and one in 2012). The matter was first presented to an administrative law judge, who denied the claimant’s request for reimbursement. The reviewing board of the Massachusetts Department of Industrial Accidents affirmed the administrative law judge’s denial of the claim on the basis that, because marijuana was an illicit substance under federal law, the Commonwealth of Massachusetts lacked the authority to order the defendant workers’ compensation insurance carrier to pay the claimant’s medical marijuana expenses. The claimant appealed.
Decision of the Supreme Judicial Court
The court affirmed the lower tribunal’s decision, resolving the issue in favor of the workers’ compensation insurance company. Although the administrative law judge and the reviewing board had based their decisions largely on the pre-emption of federal law, the supreme judicial court found support for its decision in the Commonwealth’s medical marijuana act. In denying the employee’s claim for reimbursement of the medical marijuana expense, the court pointed out a provision to the effect that nothing in the law required any health insurance provider to reimburse any person for the expense of medical usage of marijuana (Mass. Gen. Laws ch. 94I, § 6 (i)). Although the statute addressed health insurers rather than workers’ compensation insurers, the court found that the result was the same. According to the court, “it [was] one thing” to authorize the use of a substance that was illegal under federal law but “quite another” to require unwilling third parties to pay for such use and to risk prosecution as a result.
Contact a Cape Cod Workers’ Compensation Lawyer About Your Injury
If you have been hurt at work and have questions about the responsibilities that your employer and its workers’ compensation company have toward you, you need to speak to an attorney who is experienced in these types of cases. To schedule an appointment to learn more about your legal rights, contact the Law Offices of John C. Manoog III at 888-262-6664 or through the contact form on this website. One of our helpful workers’ compensation attorneys will be glad to talk to you about your case.